Self-reported effects of cold temperature exposure in persons with tetraplegia

Objective: Cervical spinal cord injury (tetraplegia) is known to interrupt sympathetic vasculature control, thereby preventing shunting of blood from the periphery to central organs when exposed to cold temperatures. As a result, persons with tetraplegia are at risk to develop hypothermia. However, information regarding the discomfort experienced during the cooler months (late fall, winter, early spring) is overwhelmingly anecdotal. It is not known, with any certainty, how those with tetraplegia perceive cold and if discomfort in colder environments restricts them from performing activities that they routinely would perform. Design: Prospective, two-group, self-report surveys. Setting: VA Medical Center and Kessler Institute for Rehabilitation. Participants: Forty-four subjects with tetraplegia; 41 matched non-SCI controls. Outcome Measures: Tetraplegic and control groups responded “yes” or “no” when asked whether cold seasonal temperatures allowed comfort or negatively affected participation in routine activities. Results: Percentage of responses of tetraplegia compared to controls was different as to whether they felt cold when others in the same room were comfortable (82 vs. 24%; χ² = 28.2, P < 0.0001), felt comfortable outdoors (17 vs. 43%; χ² = 6.8, P = 0.009), or whether cold negatively affected bathing routines (55 vs. 15%; χ² = 14.8, P = 0.0001), keeping physician appointments (46 vs. 12%; χ² = 11.3, P = 0.0008), thinking clearly (41 vs. 7%; χ² = 12.9, P = 0.0003), and completing usual work duties (46 vs. 10%; χ² = 13.3, P = 0.0003). Conclusion: Cold seasonal temperatures have a reported greater negative impact on personal comfort and ability to perform vital activities in persons with tetraplegia than that of non-SCI controls. These findings highlight the need to address thermoregulatory impairment in persons with tetraplegia.